Elcs general anaesthetic

[TreasureInMyTummy]

Hello,

I'm just over 33 weeks and I had an appointment with the anaesthetist today.

I have gestation diabetes, I have a suspected slipped disc in tail bone and sciatica and 9 years ago I had surgery on my back to remove another slipped disc ( L5 area)

Anaesthetist agreed vaginal birth could make current back problem worse ( also no position I could go in to give birth that would not be painful).

He said most anaesthetists would not do epidural or spinal tap due to unknown probs plus existing scar tissue from previous op - mostly due to where could insert needle and not even coverage and might not last as long during a c section.

So told me to have a think but advised a general anaesthetic with elective c section.

Sadly still getting my head round not seeing my baby straight away and being completely out of it but I also had some practical questions hoping for advice:

1. how long did it take you to wake up
   
2. do they give me any painkiller before putting catheter in? ( they mention in the info leaflet for c section with spinal tap but don't seem to with GA)
   
3. when you first woke up did you remember you were going to have a baby?
   
4. do you remember first seeing your baby?
   
5. can they feed baby colostrum while you are out to help with insulin ( bearing in mind I have Gestational diabetes)
   
6. did your baby have any breathing problems due to GA?
   
7. how long did you stay in hospital after?
   
8. what painkillers did you have? Can you breastfeed with painkillers?
   
   Any advice or tips to make it a better experience? All I hear is avoid a general anaesthetic and feel sad that this is my option.
   
   Thanks in advance xx

[Callmecordelia]

I had a general anaesthetic. Crash section.

The overwhelming feeling is thankful that DS and I are fine. I had a vaginal birth last time, and I don't feel short changed. It was medically necessary so I don't worry/think about it really.

I have no idea how long it took for me to come round. I don't know what they used to put me under, but it was the most wonderful dream I have ever had, and I remember fighting waking up. I didn't remember DS at that point, but I did as soon as my eyes opened and DH was there with the baby, and smiling. That was a very special moment. I held him straight away.

I had had an epidural (that didn't work) and a catheter put in as part of that, so I don't know about that in an elective situation. What was obvious is that the midwives put in and take out a lot of catheters and they were very competent - sort of like a smear test and you see a nurse who has done thousands and is very reassuring? Like that.

I had oramorph, paracetamol, Ibuprofen, and I was given a prescription for tramadol at home. I only took them twice. I breastfed on those painkillers.

DS had no breathing problems.

I didn't have gestational diabetes, so I can't help with those questions.

I hope this is reassuring. I am sorry you feel sad.

[Callmecordelia]

Bollocks, I knew I'd missed something. I had DS in the early hours of Friday morning and we went home at 6pm on Monday. Took ages to get discharged, we were waiting around all Monday afternoon.

[TreasureInMyTummy]

Thanks for replying callmecordelia mix of emotions at the moment as I was getting my head round c section with spinal tap and what I could still put in birth plan ( sheet down when baby comes out, skin to skin straight away, photos etc) now I'm wondering what I can do to make special still.

Helpful to know about catheter so many people have said glad had painkiller first as painful so unduly worried/ focused on that!

Xx

[Callmecordelia]

Best of luck. I hope that you feel better soon.

FWIW, with my DD (she's 6) I had a big birth plan, full of what I wanted. I think it fitted on one side of A4. For DS (he's 18 months now) I wrote a couple of things on the back of a business card. DD's birth taught me to roll with the punches. There's very little you can do to change the journey - you get on the train and get out at destination baby, and how you get there fades. It's a cliché, and I know you're probably sick of hearing it, but it does.

[TreasureInMyTummy]

Thanks, I originally planned for home birth in pool so I've accepted change once already. I guess it's more not seeing my baby born or being awake/ fully focused those first few hours if baby unwell due to gestational diabetes and then how long take me to recover to look after baby.

I've had a bit of a crap pregnancy with pain and now feel disappointed and worried for up and coming birth

[AndersArms]

DD (DC1) was a crash section under GA. I don't know how much later I woke up but they didn't need to feed her so can't have been too long. Once they sorted pain meds I started to feel a bit more with it.

You could ask for your DH to do skin to skin until you are awake? That would be lovely for both of them? My DH didn't hold DD until after I had woken up - he didn't want to 'rob' me of the very first cuddle. But if we had had the time to talk about it first (we really didn't, she was born 14 minutes after the decision to cs was made), I would have told him to cuddle away until I could.

I don't know about colostrum. I had GD for DC3 and they syringed some from me when I got tired to try and get more into DS2. That might be an option, if you didn't mind being poked and squeezed?

[thenewaveragebear1983]

My first section was under GA. I think it was probably an hour until I woke up. It didn't affect bonding or breastfeeding at all. Dh held the baby in the delivery suite while my surgery was completed.

However, compared with my (2nd) elcs under epidural the recovery from my 1st was longer. It was much more painful when I came round too, as with a spinal they gradually wear off whereas GA stops immediately.

They pretty much refused me a GA for my second cs, so the fact that they seem to think you will have one would suggest that they think it is definitely a medical necessity for you to have it?

[Lightsoutandawaywego]

I also have a slipped disc in my back (L5 S1) with sciatica and have just had an ELCS. I said to the anaesthetist beforehand that I was worried about them putting the needle in and damaging that disc even more but he assured me that there were other areas above that they could insert the needle to keep away from that area. You said you have scarring from ur op, but surely they could work around that? Makes me wonder if you should possibly try to get a second opinion (if there’s enough time) just to make sure you’re getting the correct information. It’d be awful to have general anaesthetic if there was no need or a way around it. Good luck. X

[Polly99]

1. I think about an hour to wake up fully enough to hold DD, altogether they did start waking me up quickly. DH had skin to skin in the meantime (I had an awake section with DD1 and he held her for ages then too as I was puking)
   
   
2. I was asleep when they put the catheter in. I've had it done awake too (see 7 below) and it was a bit embarrassing but not painful.
   
   
3. and 4) yes
   
   
4. I don't know - I was only out for an hour, and they put her straight on my boob when I saw her. I'd guess if you manage to pump some they could.
   
   6). No
   
   
5. probably 4 days, which was the same as my other cs. I had problems after both, in the case of the second one my body forgot how to pee and I had to have a catheter for a few days until it remembered.
   
   8). Not enough! I didn't want morphine and the alternative initially was paracetamol which is not adequate. Then they gave me something else -cocodemol maybe. I breastfed both my girls.
   
   I really don't think a GA is all that bad. You still get a baby afterwards and all I really felt was relief that she was ok - mine was a crash cs at the end of labour and I just wanted DD alive. it was more painful afterwards than my awake section because I hadn't had an epidural so do have an advance conversation with them about pain relief.

[over40andpregnant]

I just had one last week as an emergency

Had baby at 6pm. Did not see her till 8pm but she was with dh

Feeding no issue they obviously had to wait for me

Cathater not painful and out in in labour

No issue with bonding. She is perfect

Don’t worry too much you get the same result a healthy birth for both of you

[over40andpregnant]

Sorry I did remember having a baby it was my first question was is the baby ok

And I stayed in for 4 days. Would have been 3 but my dd had a temp at home so I stayed in an extra day to avoid it

[GuntyMcGee]

Hi OP,

Catheter is usually put in once you're anaesthetised so you won't feel it. Even if you were awake, they will use a numbing and antibacterial gel so that you shouldn't feel it going in.

With feeding baby, if you've expressed colostrum you could bring some with you (in a milk syringe) and your DH could give that to baby shortly after birth, however you won't be asleep for more than an hour and you'll be offered skin to skin and to try to breastfeed as soon as you're conscious enough to hold baby. It may be worth expressing and bringing it to hospital but saving it for if baby's blood sugar drops. Newborns can usually maintain their blood sugars for a little while after birth - they won't be checking baby's blood sugars until he/she is at least 3 hours old anyway.

Even though you'll be unconscious for the birth you can still put together a birth preference list, which can outline things like your partner to have skin to skin in recovery until you're awake and able to hold baby. Things like asking the midwife to wait until you're awake to weigh baby and do the top to toe check so that you can be involved.

Have a look at Leigh East's Ceasarean Section book - it's a really comprehensive look at planned and unplanned C-section, what happens, what recovery is like etc.

Just be aware that post GA pain can be intense so make sure that you're asking for pain relief as soon as you need it. Under spinal, the post op pain is held off until the spinal has worn off, whereas with GA it can be more immediate.

[duckduckmouse]

Hello,

You sound similar to me in wanting a home birth.
I was not eligible for an epidural or spinal block and had to have a GA.

My son was premature and it was an emergency section. They placed him on me in recovery briefly before he went to special care. I can hardly remember it.

I was on the ward through the night alone and my husband stayed with my son.

I would have loved an epidural to be able to be with my son.

I always think about it and feel upset but if your baby doesn't go to special care I am sure it will be an easier experience.

As time goes by it's less important to me. I'm just so glad my son is here.

[duckduckmouse]

Oh and one more thing. They do it very quickly with a GA so I had the catheter put in whilst conscious and I was very bruised afterwards. Approx 4 days after section the pain reduced significantly

Xx

[sycamore54321]

I can't answer on the specifics but I would suggest you think about where your ideas of the "special" things during the birth come from, and are they really your ideas? There is a very pervasive push in our culture, particularly online forums, for specific things that need to happen to bond with your baby - top of the heap is the unmedicated home water birth and so on to the 'natural' c-section with lowered screen, feeding on the operating table, etc. It presumes that all mothers and babies need steps XYZ to happen in exactly at exactly the right time in order for some perfect magic to occur. I personally think it's horse manure. You don't need to do anything to make the day your baby is born special - it's by definition special. You are facing very unusual circumstances and I can understand how you need to process the shock of the fact that the safest way for your baby to be born is while you are knocked out. And yes you will miss the moment of birth. But you will always have the moment when you first set eyes on your baby, when you first hold him, etc. It's very different certainly to what the vast majority of us experience but it's your baby's birth and that is what will be special for you.

I really hope this doesn't sound dismissive. I've tried to reword it. I just really find worrying this blasted one-size-fits-all vision of perfect birth that sets so many women up to feel failure.

Congratulations and best wishes for a safe delivery and a healthy baby and mother.

[CakesRUs]

My first was Emergency Section under GA after a long labour, they couldn't put an epidural in, I have a row of circle scars up my lower back where they tried for an hour. My next two were spinal injection sections. I can honestly say it didn't affect bonding, I don't feel disappointed, because my children were safely born. My husband found the experience extremely emotional and his bonding experience was intense and unexpected. It was like a switch had been thrown, I have wondered if that would've been the case, to that extent, if I'd had a vaginal birth and been more "present". Good luck, enjoy your baby, it's going to be lovely 😊